Provider Demographics
NPI:1992039481
Name:EUGENE M. AZUMA, D.D.S., INC.
Entity type:Organization
Organization Name:EUGENE M. AZUMA, D.D.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:M
Authorized Official - Last Name:AZUMA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:808-528-2221
Mailing Address - Street 1:1060 YOUNG ST STE 220
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-1609
Mailing Address - Country:US
Mailing Address - Phone:808-528-2221
Mailing Address - Fax:808-528-1116
Practice Address - Street 1:1060 YOUNG ST STE 220
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-1609
Practice Address - Country:US
Practice Address - Phone:808-528-2221
Practice Address - Fax:808-528-1116
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-30
Last Update Date:2009-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDT-1658122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty